This trial is active, not recruiting.

Condition acute respiratory infections (aris)
Treatment posted commitment letter
Sponsor University of Southern California
Collaborator National Institutes of Health (NIH)
Start date February 2012
End date May 2012
Trial size 14 participants
Trial identifier NCT01767064, RC4AG039115, USCalifornia


Inappropriate antibiotic prescribing for acute respiratory infections (ARIs) persists despite decades of intervention efforts. Negative outcomes of inappropriate antibiotics include increased costs of care, adverse drug reactions, and rising prevalence of antibiotic-resistant bacteria. To address this public health problem, we apply the principles of commitment and consistency in an effort to influence clinician decision-making through the implementation of a low-cost behavioral "nudge" in the form of a simple public commitment device. Clinicians were asked to post in their exam room a signed letter indicating their commitments to reducing inappropriate antibiotic use for ARIs. Our hypothesis is that clinicians displaying the poster-sized commitment letters will decrease their inappropriate antibiotic prescribing for ARIs as compared to clinicians in the control condition (with no posted letter).

United States No locations recruiting
Other countries No locations recruiting

Study Design

Allocation randomized
Intervention model parallel assignment
Masking open label
Primary purpose health services research
The poster-sized (18x24 inches) commitment letter, written at the 8th grade reading-level and displayed in English and Spanish, emphasize clinician commitment to guidelines for appropriate antibiotic prescribing and explain why antibiotics are not appropriate in many cases. These letters, featuring clinician photographs and signatures, are displayed in clinician exam rooms for a 16-week period.
posted commitment letter
(No Intervention)
Usual care with no posted letters.

Primary Outcomes

Rate of inappropriate antibiotic prescribing for patients with acute respiratory infections
time frame: up to 12 months post intervention

Eligibility Criteria

Male or female participants at least 18 years old.

Inclusion Criteria: - Medical professionals licensed to provide care and prescribe medications (including antibiotics) - Treating adult patients (18 years of age and older) from 5 Los Angeles community clinics Exclusion Criteria: - none

Additional Information

Official title Nudging Guideline-concordant Antibiotic Prescribing Using Public Commitments
Principal investigator Jason N Doctor, Ph.D.
Trial information was received from ClinicalTrials.gov and was last updated in January 2013.
Information provided to ClinicalTrials.gov by University of Southern California.